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Mental Illness in the Movies

Mental illness, as portrayed in movies, is often a cliché.  But sometimes Hollywood gets it right.

Yet it seems when they do it’s often surrounded by controversy.  People rail against insensitivity and violence, portrayals of demented lives, as if people with mental illness are merely misunderstood and not culpable for their actions.  As if they all suffer some private hell where all they do is worry and all they are are victims.

Well, people with mental illness have lives that vary just as much as people without such challenges.  Some of them are sensitive and seek understanding.   Yet some of them are reprehensible and do awful things.  Movies about those characters are the ones that move me the most.

I was impressed when Joaquin Phoenix won the Oscar for his role in Joker.  Arthur Fleck, his character, does suffer a private hell and is a victim, but he can’t be forgiven or let off the hook because of things that happened to him.  He knows what he does is wrong and he tries to get help.  When the loss of social services leads to the loss of his meds, things quickly turn violent.  But I’ll get back to that.

The world in 1981, when the movie is set, was not kind to those with serious mental illness.  Cities were hell, as the recent trend toward gentrification and the droves of promising young people who flock to urban centers was a long way away.  Social services were on the chopping block and many people were tossed from state care out onto the streets.  Joker captures this grim reality in which Arthur finds himself.

It’s in this dystopian Gotham that Arthur plays out his fantasies and expresses himself to a world that has never looked back.  Soon after this period mental health services were taken over by care for the worried well, and care is readily available for people with situational depression or mild anxiety while services, media and research for the most serious mental illnesses, the ones that lead to psychosis and keep people on the street, are increasingly rare.

In fact, even on sites that dedicate themselves to mental health, like this one, you’ll barely see any mention of severe mental illness, while conditions that in 1981 were mere personal problems that didn’t require medical intervention have taken over the content.

These soft conditions have taken over services for mental illness as well.  That’s where the money is, and to doctors, therapists, researchers and pharmaceutical companies who treat these people with insurance and the ability to stay in therapy long-term the money goes.

It’s the desperation and anger of those with severe mental illness that Joker accurately portrays.

Then there’s American Psycho.  Ten years after the time of Joker the city has filled up with yuppies as the movie predicts society’s coming obsession with narcissism.  People like Arthur Fleck are prey as Patrick Bateman expresses his violence with impunity.  Society’s focus on only the individual and one’s personal gain are a tangible part of the set.

But why this inclusion of such violent films and such reprehensible characters in a list of movies that, I think, represent mental illness fairly?  Because I experienced severe mental illness that was full of psychosis in the early 80s and in the early 90s and violence, while I never acted out, featured in the forefront of my hallucinations.

These films also get behind the structural, societal violence that contributes to mental illness.  Instead of focusing only on personal experience, they open up to larger social trends that push people to the point of acting out on the worst of what’s inside of themselves.

People with mental illness don’t only suffer alone, and the causes of mental illness are broader than personal experience and brain chemistry.  These violent films place the societal violence that causes some people to break right up front.

As for the violence in the films, I don’t think it really happened.  It was all in the lead characters’ heads.  There are plenty of clues in the films, Arthur being off his meds and the rich satire of Bateman.  People who take the violence literally have no imagination and no understanding of psychosis.

For a more down to earth representation of mental illness and its impact, I recommend Punch Drunk Love.  More than any film I’ve seen it gets bipolar disorder right.  The impulses, desperation, conflict, poor decisions, fantasy world and, yes, the violence, both committed against and by protagonist Barry Egan, are all there.

In Punch Drunk Love the story moves into the 21st century, where people focus more on themselves and less on societal issues, and the world of the Egan family is smaller and more predictable.  But this world is still dysfunctional, and it influences Egan’s hidden experiences just as much as the broad themes influence the characters in Joker and American Psycho.

The brilliant thing about all three movies is that, while we’re sure the movies’ main characters are suffering from mental illness, the films never name the disease.  We can project our experience, assumptions and opinions onto the characters.  I’m sure Barry in Punch Drunk Love has bipolar disorder, because his experience is so close to my experience with bipolar disorder.  But we can’t really be sure.

Mental illness is like that.  We can’t really be sure.  That’s the most challenging thing about living with it, and the most accurate conjecture these films express.  We can’t be sure of the motivations and we can’t be sure of the facts.  The questioning, the doubts, the insecurity.  That’s the common experience of so many with mental illness and the common thread that binds these films together.  It’s also the world we find ourselves in today.  These films are less of an escape and more of a diagnosis of the time in which we live, and its impact on fragile individuals and those around them.

They hurt to watch, like a life torn by severe mental illness.

Mental Illness in the Movies

George Hofmann

After much of a life spent in and out of hospitals, jobs, and relationships, George has spent the last dozen years living successfully with bipolar disorder 1. He teaches meditation as an adjunct therapy for mental illness, and writes and speaks about the therapies of meditation, movement, and meaningful work. Visit George at or join the Facebook group Practicing Mental Illness

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APA Reference
Hofmann, G. (2020). Mental Illness in the Movies. Psych Central. Retrieved on March 30, 2020, from


Last updated: 11 Feb 2020
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